Georgia 2023-2024 Regular Session

Georgia Senate Bill SB111 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	23 LC 33 9387S
	1	+	23 LC 33 9308
	2	+	S. B. 111
2	3		- 1 -
3		-	~~The~~ Senate ~~Committee on Health and Human Services offered the following~~
4		-	~~substitute to SB 111:~~
	4	+	Senate Bill 111
	5	+	By: Senators Hufstetler of the 52nd, Watson of the 1st and Kirkpatrick of the 32nd
5	6		A BILL TO BE ENTITLED
6	7		AN ACT
7		-	To amend Title 43 of the Official Code of Georgia Annotated, relating to professions and1
	8	+	To amend Title 43 of the Official Code of Georgia Annotated, relating to professions and
	9	+	1
8	10		businesses, so as to enact the "Anesthesiologist Assistant Act"; to provide for an2
9	11		anesthesiologist assistant to be appointed in an advisory capacity to the Georgia Composite3
10	12		Medical Board; to provide for definitions; to provide for powers and duties of the Georgia4
11	13		Composite Medical Board as they relate to anesthesiologist assistants; to provide for5
12	14		licensure rules and requirements; to define the scope of practice for anesthesiologist6
13	15		assistants; to provide for regulation of the profession; to provide for rules and requirements7
14	16		for licensure reinstatement; to provide for penalties for unauthorized practice; to provide for8
15	17		practice during emergencies; to provide for related matters; to repeal conflicting laws; and9
16	18		for other purposes.10
17	19		BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11
18	20		SECTION 1.12
19	21		Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,13
20	22		is amended in Chapter 34, relating to physicians, acupuncture, physician assistants, cancer14
21	23		and glaucoma treatment, respiratory care, clinical perfusionists, and orthotics and prosthetics15
22		-	practice, by revising subsection (e) of Code Section 43-34-2, relating to creation of board,16 23 LC 33 9387S
	24	+	practice, by revising subsection (e) of Code Section 43-34-2, relating to creation of board,16 23 LC 33 9308
	25	+	S. B. 111
23	26		- 2 -
24		-	members, physician assistants advisory committee, review of qualifications, and required17
	27	+	members, physician assistants advisory committee, review of qualifications, and required
	28	+	17
25	29		training, as follows:18
26	30		"(e)(1) The board shall appoint a Physician Assistants Advisory Committee composed19
27	31		of four physicians, at least two of whom shall be members of the board, and four licensed20
28	32		physician assistants, who shall each serve for terms of office of two years and until their21
29	33		successors are appointed and qualified. The committee shall review matters to come22
30		-	before the board which relate to physician assistants, including, but not limited to,23
	34	+	before the board which relate to physician assistants, including,
	35	+	but not limited to,23
31	36		applicants for physician assistant licensure and relicensure and education requirements24
32	37		therefor, and proposed board regulations concerning physician assistants. The committee25
33	38		shall periodically make recommendations to the board regarding matters reviewed. Each26
34	39		member of the advisory committee shall be entitled to the same expense allowances,27
35	40		mileage allowances, and reimbursement as members of the board as provided for in this28
36	41		chapter.29
37	42		(2) The committee shall appoint a physician assistant in an advisory capacity to the30
38	43		board. The advisory person shall serve at the pleasure of the committee as an ex officio31
39	44		adviser to the board in all matters relating to physician assistants and shall share in the32
40	45		privileges and benefits of the board without a vote.33
41	46		(3) The committee shall appoint an anesthesiologist assistant in an advisory capacity to34
42	47		the board. The advisory person shall serve at the pleasure of the committee as an ex35
43	48		officio adviser to the board in all matters relating to anesthesiologist assistants and shall36
44	49		share in the privileges and benefits of the board without a vote."37
45	50		SECTION 3.38
46		-	Said title is further amended in said chapter by enacting a new article to read as follows:39 23 LC 33 9387S
	51	+	Said title is further amended in said chapter by enacting a new article to read as follows:39 23 LC 33 9308
	52	+	S. B. 111
47	53		- 3 -
48	54		"ARTICLE 1340
49	55		43-34-320.41
50	56		This article shall be known and may be cited as the 'Anesthesiologist Assistant Act.'42
51	57		43-34-321.43
52	58		As used in this article, the term:44
53	59		(1) 'Alternate supervising anesthesiologist' means an anesthesiologist to whom a board45
54	60		approved supervising anesthesiologist has delegated the responsibility of supervising an46
55	61		anesthesiologist assistant and who agrees to supervise the anesthesiologist assistant for47
56	62		the supervising anesthesiologist and who is on record with the board.48
57	63		(2) 'Anesthesiologist' means a physician licensed pursuant to this chapter who has49
58	64		completed a residency in anesthesiology approved by the American Board of50
59	65		Anesthesiology or the American Osteopathic Board of Anesthesiology.51
60	66		(3) 'Anesthesiologist assistant' means a person who has met the requirements of Code52
61	67		Section 43-34-323 and is licensed to practice medicine under the supervision of an53
62	68		anesthesiologist.54
63	69		(4) 'Certification examination' means the initial certifying examination approved by the55
64	70		board for the certification of anesthesiologist assistants, which may include the56
65	71		examination administered by the National Commission for the Certification of57
66	72		Anesthesiologist Assistants or other national anesthesiologist assistant certifying agency58
67	73		that has been reviewed and approved by the board.59
68	74		(5) 'Immediately available' means that a supervising anesthesiologist is immediately60
69	75		available if he or she is in physical proximity that allows the anesthesiologist to61
70	76		reestablish direct contact with the patient to meet medical needs and any urgent or62
71	77		emergent clinical problems. These responsibilities may also be met through coordination63
72		-	among anesthesiologists of the same group or department.64 23 LC 33 9387S
	78	+	among anesthesiologists of the same group or department.64 23 LC 33 9308
	79	+	S. B. 111
73	80		- 4 -
74	81		(6) 'Job description' means a document, signed by the supervising anesthesiologist and65
75	82		the anesthesiologist assistant whom the supervising anesthesiologist is supervising, in66
76	83		which the supervising anesthesiologist delegates to that anesthesiologist assistant67
77	84		authority to perform certain medical acts and which describes the professional68
78	85		background and specialty of the supervising anesthesiologist; describes the qualifications,69
79	86		including related experience of the anesthesiologist assistant; and includes a general70
80	87		description of how the anesthesiologist assistant will be utilized in the practice. A job71
81	88		description shall not be required to contain every activity the anesthesiologist deems the72
82	89		anesthesiologist assistant qualified to perform but shall confine the activities of the73
83	90		anesthesiologist assistant to those in the scope of practice of the supervising74
84	91		anesthesiologist.75
85	92		(7) 'Supervising anesthesiologist' means the anesthesiologist who has the primary76
86	93		responsibility for supervising the practice of an anesthesiologist assistant pursuant to that77
87	94		anesthesiologist assistant's job description.78
88	95		(8) 'Supervision' means the availability of an anesthesiologist to delegate, coordinate,79
89	96		direct, and consult on the implementation of his or her intentions.80
90	97		43-34-322.81
91	98		(a) The board shall review and determine the qualifications and fitness of all persons82
92	99		applying for a license to practice as an anesthesiologist assistant.83
93	100		(b) The board shall:84
94	101		(1) Grant, deny, revoke, and reinstate licenses;85
95	102		(2) Investigate allegations regarding improper conduct by anesthesiologist assistants that86
96	103		would be grounds for revocation of licensure;87
97	104		(3) Conduct informal interviews and hearings;88
98		-	(4) Adopt rules governing the practice of anesthesiologist assistants; and89 23 LC 33 9387S
	105	+	(4) Adopt rules governing the practice of anesthesiologist assistants; and89 23 LC 33 9308
	106	+	S. B. 111
99	107		- 5 -
100	108		(5) Retain jurisdiction over all licensees who receive temporary or full licenses under this90
101	109		article, regardless of whether the license has expired or lapsed, or was relinquished during91
102	110		or after any alleged occurrence of conduct.92
103	111		43-34-323.93
104	112		(a) A person shall not practice in this state as an anesthesiologist assistant or use the title94
105	113		or otherwise represent that the person is a licensed anesthesiologist assistant or use the95
106	114		credentials 'A.A.', 'C.A.A.', or anesthetist without having a license granted by the board96
107	115		pursuant to this article.97
108	116		(b) The board may grant an anesthesiologist assistant license to an applicant who:98
109	117		(1) Graduated from an anesthesiologist assistant program accredited by the Commission99
110	118		on Accreditation of Allied Health Education Programs or its predecessor or successor100
111	119		organization;101
112	120		(2) Successfully completed a certification examination and that is or was certified as of102
113	121		July 1, 2023, or was licensed in this state as a physician assistant in anesthesiology as of103
114	122		July 1, 2023;104
115	123		(3) Completes an application form prescribed by the board; and105
116	124		(4) Pays the required application fees as prescribed by the board in its rules.106
117	125		(c) A license issued pursuant to this article, other than a temporary license, shall be valid107
118	126		for a period of two years. A licensee shall renew the license every other year by108
119	127		completing and submitting to the board a renewal application form as prescribed by the109
120	128		board and the prescribed renewal fee before the current license expires. The board shall110
121	129		provide renewal notices to licensees at least one month before the expiration date.111
122	130		(d) The board may reinstate a lapsed license if the applicant pays a reinstatement fee as112
123	131		prescribed by the board in rule and meets the requirements for initial licensure.113
124	132		(e) Any person who has not successfully completed a certification examination may be114
125		-	issued a temporary license by the board if such person:115 23 LC 33 9387S
	133	+	issued a temporary license by the board if such person:115 23 LC 33 9308
	134	+	S. B. 111
126	135		- 6 -
127	136		(1) Completes a temporary license application;116
128	137		(2) Pays the required temporary license fee as prescribed by the board in rule; and117
129	138		(3) Has successfully graduated from a program accredited by the Commission on118
130	139		Accreditation of Allied Health Education Programs, or another board approved program119
131	140		for educating and training anesthesiologist assistants.120
132	141		Such person shall take the next available certification examination after receiving a121
133		-	temporary license. A temporary license shall not be issued for a period of more ~~than122~~
134		-	~~90 days~~ and is subject to any other requirements the board adopts by rule.123
	142	+	temporary license. A temporary license shall not be issued for a period of more than one122
	143	+	year and is subject to any other requirements the board adopts by rule.123
135	144		43-34-324.124
136	145		(a) This Code section shall not apply to persons who are enrolled in an anesthesiologist125
137	146		assistant education program approved by the board.126
138	147		(b) An anesthesiologist assistant may practice medicine only under the supervision of an127
139	148		anesthesiologist. The anesthesiologist assistant may perform only those duties and128
140	149		responsibilities delegated to the anesthesiologist assistant by the supervising129
141	150		anesthesiologist pursuant to a job description.130
142	151		(c) The supervising anesthesiologist or an alternate supervising anesthesiologist shall be131
143	152		allowed to supervise anesthesiologist assistants in a manner consistent with federal rules132
144	153		or regulations for reimbursement for anesthesia services.133
145	154		(d) The supervising anesthesiologist or an alternate supervising anesthesiologist shall be134
146	155		immediately available to the anesthesiologist assistant such that the supervising135
147	156		anesthesiologist or an alternate supervising anesthesiologist is able to intervene if needed136
148	157		in the delivery of medical care.137
149	158		(e) An anesthesiologist assistant's practice may not exceed his or her education, training,138
150	159		or the scope of practice of the supervising anesthesiologist or an alternate supervising139
151		-	anesthesiologist.140 23 LC 33 9387S
	160	+	anesthesiologist.140 23 LC 33 9308
	161	+	S. B. 111
152	162		- 7 -
153	163		(f) Nothing in this article shall prevent an anesthesiologist assistant from having access to141
154	164		and being able to administer prescription drugs as directed by the supervising142
155	165		anesthesiologist or an alternate supervising anesthesiologist.143
156	166		43-34-325.144
157	167		(a) A supervising anesthesiologist or an alternate supervising anesthesiologist may145
158	168		delegate the authority contained in subsection (b) of this Code section to an146
159	169		anesthesiologist assistant in accordance with a job description.147
160	170		(b) A supervising anesthesiologist or an alternate supervising anesthesiologist may148
161		-	delegate to an anesthesiologist assistant the authority to order controlled substances149
162		-	selected from a formulary of such drugs established by the board and the authority to order150
163		-	dangerous drugs, medical treatments, and diagnostic studies.151
164		-	(c) An anesthesiologist assistant authorized by a supervising anesthesiologist to order152
165		-	controlled substances pursuant to this Code section is authorized to register with the United153
166		-	States Drug Enforcement Administration.154
167		-	43-34-326.155
168		-	The board shall have all authority to impose on an anesthesiologist assistant any sanction156
169		-	authorized under Code Section 43-34-8 upon a finding of any conduct specified in Code157
170		-	Section 43-34-8.158
171		-	43-34-327.159
172		-	(a) The board may issue a new license to an anesthesiologist assistant whose license was160
173		-	previously revoked by the board if the applicant applies in writing to the board and161
174		-	demonstrates to the board's satisfaction that the applicant is completely rehabilitated with162
175		-	respect to the conduct that was the basis for the revocation. In making its decision, the163
176		-	board shall determine:164 23 LC 33 9387S
	171	+	delegate to an anesthesiologist assistant:149
	172	+	(1) The authority to order controlled substances selected from a formulary of such drugs150
	173	+	established by the board and the authority to order dangerous drugs, medical treatments,151
	174	+	and diagnostic studies;152
	175	+	(2) The authority to request, receive, and sign for professional samples and to distribute153
	176	+	professional samples to patients. The office or facility at which the anesthesiologist154
	177	+	assistant is working shall maintain a general list of the professional samples approved by155
	178	+	the delegating anesthesiologist for request, receipt, and distribution by the156
	179	+	anesthesiologist assistant as well as a complete list of the specific number and dosage of157
	180	+	each professional sample and medication voucher received. Professional samples that are158
	181	+	distributed by an anesthesiologist assistant shall be so noted in the patient's medical159
	182	+	record. In addition to the requirements of this Code section, all professional samples160
	183	+	shall be maintained as required by applicable state and federal laws and regulations; and161
	184	+	(3) The authority to sign, certify, and endorse all documents relating to health care162
	185	+	provided to a patient within his or her scope of authorized practice, including, but not163
	186	+	limited to, documents relating to physical examination forms of all state agencies and164
	187	+	verification and evaluation forms of the Department of Human Services, the State Board165
	188	+	of Education, local boards of education, the Department of Community Health, and the166 23 LC 33 9308
	189	+	S. B. 111
177	190		- 8 -
178		-	(1) Whether the applicant has engaged in any conduct during the revocation period that165
179		-	would constitute a basis for revocation pursuant to rules adopted by the board;166
180		-	(2) If a criminal conviction was a basis of the revocation, whether the applicant's civil167
181		-	rights have been fully restored pursuant to statute or judicial or executive order;168
182		-	(3) Whether the applicant has made restitution to any aggrieved person as ordered by a169
183		-	court of competent jurisdiction; and170
184		-	(4) Whether the applicant demonstrates any other standard of rehabilitation the board171
185		-	determines is appropriate.172
186		-	(b) Except as provided in subsection (c) of this Code section, a person shall not apply for173
187		-	license reinstatement until two years after the date of revocation.174
188		-	(c) If a license revocation was based on a conviction of a felony or an offense involving175
189		-	moral turpitude and that conviction has been reversed on appeal, the board shall reverse its176
190		-	previous order to revoke the license, and the anesthesiologist assistant may apply for177
191		-	reinstatement as soon as the court enters its reversal.178
192		-	(d) An application for reinstatement shall comply with all initial licensure requirements179
193		-	prescribed by this article and rules and regulations adopted by the board pursuant to this180
194		-	article.181
195		-	43-34-328.182
196		-	Any person practicing as an anesthesiologist assistant or representing that he or she is an183
197		-	anesthesiologist assistant without a license, or any person employing an unlicensed person184
198		-	to practice as an anesthesiologist assistant, is guilty of a misdemeanor and upon conviction185
199		-	shall be punished by a fine of not more than $1,000.00 or by imprisonment for not more186
200		-	than one year, or both. Each violation constitutes a separate offense for which the penalty187
201		-	in this Code section may be assessed.188 23 LC 33 9387S
	191	+	Department of Corrections; provided, however, that an anesthesiologist assistant shall not167
	192	+	have the authority to sign death certificates or assign a percentage of a disability rating.168
	193	+	(c) An anesthesiologist assistant authorized by a supervising anesthesiologist to order169
	194	+	controlled substances pursuant to this Code section is authorized to register with the United170
	195	+	States Drug Enforcement Administration.171
	196	+	43-34-326.172
	197	+	The board shall have all authority to impose on an anesthesiologist assistant any sanction173
	198	+	authorized under Code Section 43-34-8 upon a finding of any conduct specified in Code174
	199	+	Section 43-34-8.175
	200	+	43-34-327.176
	201	+	(a) The board may issue a new license to an anesthesiologist assistant whose license was177
	202	+	previously revoked by the board if the applicant applies in writing to the board and178
	203	+	demonstrates to the board's satisfaction that the applicant is completely rehabilitated with179
	204	+	respect to the conduct that was the basis for the revocation. In making its decision, the180
	205	+	board shall determine:181
	206	+	(1) Whether the applicant has engaged in any conduct during the revocation period that182
	207	+	would constitute a basis for revocation pursuant to rules adopted by the board;183
	208	+	(2) If a criminal conviction was a basis of the revocation, whether the applicant's civil184
	209	+	rights have been fully restored pursuant to statute or judicial or executive order;185
	210	+	(3) Whether the applicant has made restitution to any aggrieved person as ordered by a186
	211	+	court of competent jurisdiction; and187
	212	+	(4) Whether the applicant demonstrates any other standard of rehabilitation the board188
	213	+	determines is appropriate.189
	214	+	(b) Except as provided in subsection (c) of this Code section, a person shall not apply for190
	215	+	license reinstatement until two years after the date of revocation.191 23 LC 33 9308
	216	+	S. B. 111
202	217		- 9 -
203		-	43-34-329.189
204		-	(a) Notwithstanding any provision of this article to the contrary, an anesthesiologist190
205		-	assistant licensed pursuant to this article or licensed, certified, or otherwise authorized to191
206		-	practice in any other state or federal jurisdiction and whose license, certification, or192
207		-	authorization is in good standing who responds to a need for medical care created by193
208		-	conditions which characterize those of a state of emergency or public health emergency194
209		-	may render such care that the anesthesiologist assistant is able to provide with such195
210		-	supervision as is available at the immediate scene or at the local site where such need for196
211		-	medical care exists or at a relief site established as part of a state or local safety plan197
212		-	established pursuant to Chapter 3 of Title 38. Such services shall be provided by an198
213		-	anesthesiologist assistant in response to the request of an appropriate state or local official199
214		-	implementing a state or local emergency management plan or program, and in accordance200
215		-	with applicable guidelines established by such officials or plans. The authority granted by201
216		-	this Code section shall last no longer than 48 hours or such time as the board may establish202
217		-	under guidelines for supervision of the anesthesiologist assistant rendering medical care.203
218		-	(b) For the purposes of this Code section, the term 'public health emergency' has the same204
219		-	meaning as in paragraph (6) of Code Section 38-3-3, and the term 'state of emergency' has205
220		-	the same meaning as in paragraph (7) of Code Section 38-3-3."206
221		-	SECTION 4.207
222		-	All laws and parts of laws in conflict with this Act are repealed.208
	218	+	(c) If a license revocation was based on a conviction of a felony or an offense involving192
	219	+	moral turpitude and that conviction has been reversed on appeal, the board shall reverse its193
	220	+	previous order to revoke the license, and the anesthesiologist assistant may apply for194
	221	+	reinstatement as soon as the court enters its reversal.195
	222	+	(d) An application for reinstatement shall comply with all initial licensure requirements196
	223	+	prescribed by this article and rules and regulations adopted by the board pursuant to this197
	224	+	article.198
	225	+	43-34-328.199
	226	+	Any person practicing as an anesthesiologist assistant or representing that he or she is an200
	227	+	anesthesiologist assistant without a license, or any person employing an unlicensed person201
	228	+	to practice as an anesthesiologist assistant, is guilty of a misdemeanor and upon conviction202
	229	+	shall be punished by a fine of not more than $1,000.00 or by imprisonment for not more203
	230	+	than one year, or both. Each violation constitutes a separate offense for which the penalty204
	231	+	in this Code section may be assessed.205
	232	+	43-34-329.206
	233	+	(a) Notwithstanding any provision of this article to the contrary, an anesthesiologist207
	234	+	assistant licensed pursuant to this article or licensed, certified, or otherwise authorized to208
	235	+	practice in any other state or federal jurisdiction and whose license, certification, or209
	236	+	authorization is in good standing who responds to a need for medical care created by210
	237	+	conditions which characterize those of a state of emergency or public health emergency211
	238	+	may render such care that the anesthesiologist assistant is able to provide with such212
	239	+	supervision as is available at the immediate scene or at the local site where such need for213
	240	+	medical care exists or at a relief site established as part of a state or local safety plan214
	241	+	established pursuant to Chapter 3 of Title 38. Such services shall be provided by an215
	242	+	anesthesiologist assistant in response to the request of an appropriate state or local official216 23 LC 33 9308
	243	+	S. B. 111
	244	+	- 10 -
	245	+	implementing a state or local emergency management plan or program, and in accordance217
	246	+	with applicable guidelines established by such officials or plans. The authority granted by218
	247	+	this Code section shall last no longer than 48 hours or such time as the board may establish219
	248	+	under guidelines for supervision of the anesthesiologist assistant rendering medical care.220
	249	+	(b) For the purposes of this Code section, the term 'public health emergency' has the same221
	250	+	meaning as in paragraph (6) of Code Section 38-3-3, and the term 'state of emergency' has222
	251	+	the same meaning as in paragraph (7) of Code Section 38-3-3."223
	252	+	SECTION 4.224
	253	+	All laws and parts of laws in conflict with this Act are repealed.225